正常胰膽管及急性胰腺炎胰管改變的MRI研究
發(fā)布時(shí)間:2018-07-06 14:34
本文選題:成人 + 膽道 ; 參考:《川北醫(yī)學(xué)院》2014年碩士論文
【摘要】:目的:利用MRI測(cè)量正常膽總管最大直徑,擬定其上限值;并分析其與年齡、性別等及其它重要因素的關(guān)系。 材料與方法:743例無(wú)肝、膽、胰疾病者,其中包括203例志愿者。在MRCP圖像上測(cè)量膽總管的最大直徑。統(tǒng)計(jì)患者的年齡、性別,測(cè)量門(mén)靜脈管徑、肝外膽管長(zhǎng)度和膽總管長(zhǎng)度,觀察膽囊管匯入肝外膽管位置的高低及匯入方向。對(duì)志愿者還統(tǒng)計(jì)其身高、體重、體重指數(shù)(body massindex,BMI),測(cè)量其深吸氣屏氣相MRCP圖像上膽總管最大直徑。依據(jù)年齡將患者分為7個(gè)組。并對(duì)膽總管直徑與上述各種因素間關(guān)系進(jìn)行分析。 結(jié)果:膽總管直徑的平均值為(4.16±1.77)mm,范圍1.98~7.08mm。60歲前膽總管直徑的上限值為5mm,60歲后膽總管直徑上限值為6mm。膽總管直徑與年齡間呈正相關(guān)關(guān)系(r=0.491,P<0.05)。隨年齡增加,膽總管直徑每年增加0.032mm。60歲之后膽總管直徑較60歲前膽總管直徑大(P<0.05)。膽總管直徑與性別、呼吸、身高、體重、體重指數(shù)、門(mén)靜脈管徑、肝外膽管長(zhǎng)度、膽總管長(zhǎng)度、膽囊匯入肝外膽管位置的高低及匯入方向間不存在統(tǒng)計(jì)學(xué)差異(P>0.05)。 結(jié)論:隨年齡增加膽總管直徑增加。60歲前膽總管直徑上限值5mm,60歲后膽總管直徑上限值6mm,超過(guò)該值認(rèn)為膽總管擴(kuò)張。 目的:研究正常胰管的3.0T磁共振表現(xiàn)。 材料與方法:203例健康志愿者,MR檢查包括T1WI、T2WI、MRCP。管的觀察序列包括軸位、冠狀位T2WI及MRCP。觀察各段胰管顯示況、走行及變異。 結(jié)果:胰腺頭、體、尾主胰管顯示率99.51%、98.52%、93.10%;副管及分支胰管顯示率34.00%、9.85%;胰腺分裂檢出率5.91%;胰腺頭、、尾主胰管平均直徑(2.46±0.22)mm、(2.19±0.19)mm、(1.98±0.60)mm;胰管的平均長(zhǎng)度及平均直徑分別為(26.74±8.67)mm,(1.60±0.31)mm;管走行:下降型,占74.87%(152/203);“S”型,占11.33%(23/203);直型,,占9.36%(19/203);環(huán)形,占4.44%(9/203)。 結(jié)論:MRI能滿意顯示胰管正常解剖及變異。 目的:研究急性胰腺炎胰管改變的MRI表現(xiàn)。 材料與方法:收集239例急性胰腺炎患者及125例對(duì)照組。依據(jù)急性生理和慢性健康評(píng)估Ⅱ(Acute physiology and chronic health evaluation,APACHEⅡ)和MR嚴(yán)重指數(shù)(MR severity index,MRSI)對(duì)急性胰腺炎嚴(yán)重程度進(jìn)行評(píng)分。在MRI圖像上觀察主胰管(main pancreatic duct,MPD)顯影段,測(cè)量主胰管直徑,觀察有無(wú)胰管破裂,并研究其與急性胰腺炎嚴(yán)重程度的關(guān)系。 結(jié)果:急性胰腺炎患者胰管顯影段較對(duì)照組低(P<0.05)。胰管顯影段與APACHE Ⅱ評(píng)分(P0.05)及MRSI評(píng)分(P0.05)間呈負(fù)相關(guān)關(guān)系。急性胰腺炎與對(duì)照組胰管直徑無(wú)差異(P0.05)。急性胰腺炎不同嚴(yán)重程度間胰管直徑無(wú)差異(P0.05)。急性胰腺炎胰管破裂的發(fā)生率為7.9%。APACHEⅡ評(píng)分輕型和重型胰腺炎胰管破裂的發(fā)生率分別為4.8%和15.3%。MRSI評(píng)分輕度、中度及重度胰腺炎胰管破裂的發(fā)生率分別為0%,5.7%和43.5%。胰管破裂與APACHEⅡ評(píng)分(P0.05)及MRSI(P0.05)間呈正相關(guān)。 結(jié)論:急性胰腺炎患者主胰管直徑在正常范圍。MRI圖像上胰管顯影段及胰管破裂可以作為評(píng)估和預(yù)測(cè)急性胰腺炎嚴(yán)重程度另一種簡(jiǎn)單的輔助指標(biāo)。
[Abstract]:Objective : To measure the maximum diameter of normal bile duct by MRI , and to formulate its upper limit value ;
Its relationship with age , sex and other important factors is analyzed .
Materials and Methods : There were 743 patients without liver , gallbladder and pancreatic diseases , including 203 volunteers . The maximum diameter of the common bile duct was measured on the MR images . The height , weight and body mass index ( BMI ) of the bile duct were measured . The height , body weight and body mass index ( BMI ) were measured . The height , body weight and body mass index ( BMI ) were measured . The height , body weight and body mass index ( BMI ) were measured . The height , body weight and body mass index ( BMI ) of the gallbladder tube were measured . The patients were divided into 7 groups according to age . The relationship between the diameter of the common bile duct and the above factors was analyzed .
Results : The mean diameter of the common bile duct was ( 4 . 16 鹵 1 . 77 ) mm , the range was 1 . 98 锝
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